# PERIPHERAL NERVE CLINIC, PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558606111
- **Authorized official:** EDDIE HANSEN DC (OWNER)
- **Authorized official phone:** (360) 933-1405

## Contact information

- **Practice address:** 2000 N STATE ST, BELLINGHAM, WA 98225-4218
- **Practice address phone:** (360) 933-1405
- **Mailing address:** 2000 N STATE ST, BELLINGHAM, WA 98225-4218
- **Mailing address phone:** (360) 933-1405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/06/2012
- **Last updated:** 12/06/2012